A 35-year-old woman lost a lot more than weight after gastric-bypass surgery she had overcome on Dec. 28, 2005.
She was taken back to the hospital, barely conscious and with weakness of all four limbs. Her brain and nervous system had been affected by a vitamin deficiency.
A 35-year-old woman lost a lot more than weight after gastric-bypass surgery she had overcome on Dec. 28, 2005.
She was taken back to the hospital, barely conscious and with weakness of all four limbs. Her brain and nervous system had been affected by a vitamin deficiency.
The woman had too little vitamin B-1 (thiamine), which was caused by appetite loss, nausea, and vomiting after surgery. That resulted in a serious deficiency and a hard-to-recognize syndrome called Wernicke encephalopathy. It is the common syndrome among alcoholics, and it can lead to permanent disability.
“A high index of suspicion for Wernicke encephalopathy is required in surgically treated obese patients,” warns Raul Mandler, MD, and colleagues at George Washington University School of Medicine.
The accident described in the Dec. 27 issue of Neurology, should be a warning for doctors and patients- to be on the lookout for signs of nervous system complications after weight loss surgery. University of Rochester neurologist Heidi Schwarz, MD, says that this is particularly important for patients who can’t stop vomiting after surgery.
Vitamin B-1 can be found in pork, legumes, grains, breads, and cereals. It is absorbed through the small intestine.
Wernicke encephalopathy has three classic symptoms: abnormal eye movement, mental confusion, and inability to coordinate muscle movements. But only one in 5 patients it has all three symptoms together.
The patient after the bariatric surgery experienced the unusual symptom of progressive hearing loss. Twelve weeks after surgery, she was confused, had problems with walking, and was very weak. By the time doctors discovered the problem and gave her intravenous doses of B-1 she suffered further decline.
